Healthcare Provider Details

I. General information

NPI: 1417185364
Provider Name (Legal Business Name): JOSE ROBERTO ARNAO O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2009
Last Update Date: 02/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6757 W NEWBERRY RD
GAINESVILLE FL
32605-4312
US

IV. Provider business mailing address

10006 NW 17TH RD
GAINESVILLE FL
32606-9274
US

V. Phone/Fax

Practice location:
  • Phone: 352-331-2040
  • Fax: 352-331-1526
Mailing address:
  • Phone: 954-347-0435
  • Fax: 352-505-6416

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPC4293
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License NumberOPC 4293
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: